Worldwide Survey of Clinician Practice on use of Adjunctive Therapies Following Botulinum Toxin Injection for Spasticity.
Fabienne Schillebeeckx, Patricia B Mills, Alvin Ip and 9 others
PMID 35801863WHAT IT FOUND
Clinicians worldwide mostly prescribe home exercise, stretching, and splinting after botulinum toxin for spasticity.
The main barriers are lack of time, money, and evidence, not patient refusal. Practice patterns are largely uniform across settings.
Key findings
01The most frequently used adjunctive therapies were active exercise at home (81%), stretching at home (81%), and splinting (70%).
02Lack of time, lack of financial resources, and insufficient scientific evidence were the main barriers to using these therapies.
03Clinicians indicated a need for more evidence for the use of any adjuvant therapy, particularly for treatments applied immediately after injection.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The survey represents only a proportion of clinicians worldwide, so it may not reflect the practice of all therapists. Nearly 25% of clinicians did not answer all items in the survey. The data is self-reported, so there may be discrepancies between what clinicians say they prescribe and what patients actually receive. The survey did not validate the questionnaire used. Respondents treated various causes of spasticity, including cerebral palsy and stroke, which may have different evidence bases and practice patterns.
Declared interests
No specific conflicts of interest or funding sources were declared in the provided text.
The easy way to misread this
Do not interpret the high usage of home exercise and stretching as proof that they are the most effective adjuncts. The survey reports what clinicians *do*, not what works best. In fact, the authors note that these therapies had the lowest compliance rates and that lack of evidence was a major barrier for many other interventions.